The Body Politic: Planning History,Design,and Public Health

The coronavirus 2019, or COVID-19, is an ongoing international pandemic. With nearly 150 million COVID cases reported and 3.2 million deaths linked to the virus, it’s now one of the deadliest public health contagions in history. The pandemic impacts different populations unequally for many reasons: from the skewed international distribution of its vaccines, to diverse subnational state and regional vaccine distribution policies, to whether or not one wishes to wear a mask, social distance, or get the vaccine if available. In the United States, evidence shows that the virus impacts communities of color in greater relative numbers than white communities, ¹ and internationally, COVID-19 disproportionately impacts those living in extreme poverty. ² In all communities, COVID-19 infects the very basic relationship between individual choices and collective consequences. It’s a story of heroisms and neglect, spread across science, technology, governance, and society; a story of power and politics. ³

The pandemic is experienced bodily by those who contract it, while family and friends are wracked with fear in the vast uncertainty of broad possible outcomes, from a benign lack of symptoms, to long-term disability and death. But the pandemic is also experienced by society as a mediated phenomenon, highly susceptible to misinformation and web agitprop. In his 1994 book Flesh and Stone, Richard Sennett presciently identified this viewing of a computer screen or a television as the body in a “narcotic state,” passive and desensitized while moving through “destinations set in a fragmented and discontinuous urban geography.” ⁴ Sennett goes on to target shopping malls and domestic comforts as the continuous “spatial aftershocks of problems before unsolved on streets and town squares, in churches and town halls, in houses and courtyards packing people close together;” ⁵ a density of people that failed to arouse or instruct how multiple bodies experience those spaces. This is the book’s premise for investigating the body and the city—flesh and stone—in Western Civilization, by using Greco-Roman, Medieval, and Enlightenment references, up through to New York’s Greenwich Village in the 1990s.

Sennett begins with the concept of the “body politic,” which he attributes to John of Salisbury in 1159 in the simple dictum that “the state {res publica} is a body” as an assertion of social order. ⁶ He traces that governing pact from a static, monarchical order based on “wholeness, oneness, coherence,” a discourse of state power over its subjects, to a body politic more sacred, multiple, infirmed and suffering, which Sennett believes can inspire a human empathy across difference toward collective civic purpose. ⁷ The sixteenth-century Jewish ghetto in Venice serves as a xenophobic reminder of oppression when such empathy is not universally extended. Jews were persecuted on various fronts in the trading republic, one of which justified the guarded ghetto sector of the city through the punitive (false) association of Jewish bodies with the spread of syphilis and leprosy. ⁸ This kind of sectoral persecution is echoed today, in the rise of violence, Sinophobia, and racist scapegoating that has accompanied the pandemic.

The remainder of Sennett’s book follows William Harvey’s 1626 discovery of the body’s circulatory systems, and how this influenced Enlightenment planners to reformulate movement in the city for the mobile homo economicus. ⁹ Thus, Nash’s Regent Park and Regent Street network, Haussmann’s boulevards, and Moses’s parkways each seek to provide circulation and ventilation for their respective cities, in concert with economic efficiency objectives. In his recent analysis of Sir Christopher Wren’s 1666 proposed plan for post-fire London, Michael Hebbert shows how the legacy of the plan that was finally not implemented took on a whole new life as a kind treatise for circulation, public health, and the Enlightenment. Hebbert writes,

The precedent of the Wren plan continued to be cited in public health texts. In Health of the City (1910) Godfrey Hollis of the London School of Hygiene and Tropical Medicine presented it as thoroughly modern in its combination of zoning (removal of industry outside the City walls), provision of garden space, and hierarchical highway design, with traffic thoroughfares separated from residential streets. ¹⁰

Hebbert points out that “sanitarianism was one of the earliest and most effective of the single-issue reform movements” of the nineteenth century and was fundamental as justification for underground clean water and sewage systems, along with removal of above-ground obstacles to free ventilation. ¹¹ He concludes that more recently, the Wren plan has been reevaluated as one of centralized top-down design, as opposed to London’s true nature as a city of many villages; familiar odes to a more organic planning and the critiques levied against planners from Haussmann to Moses. But few would argue against an infrastructural functionality that provides a cohesive structure to the city and essential public health services. In the 1840s, Edwin Chadwick, a pioneer of the town sanitary survey and an advocate for sanitary reform, even considered a private venture to pump “pure air” into people’s homes for healthy respiration and ventilation. ¹² The alternative, to make city air cleaner, was the obvious choice, although such a domestic air service may have saved lives in the contemporary pandemic.

Hebbert notes that, “In the professional family tree, public health and town planning are blood cousins, with common ancestry in the sanitary movement of the 1840s”; ¹³ each rooted to professional practice, connected to local governments, and guided by holistic ideologies that set them apart from their respective “parent disciplines” of architecture and medicine.

In the United States, before sanitary reform, public health in the early nineteenth-century functioned mainly as an,

…emergency defense mechanism. When no peril appeared imminent, apathy prevailed. Only when an epidemic loomed did public officials and health boards, many of them last-minute contrivances, leap into action. Thus, under normal circumstances, little urgency was felt to clean up the city, let alone recast it. ¹⁴

Echoing Hebbert, Jon A. Peterson claims that sanitary reform was a precursor to twentieth-century city planning, not a direct cause, by establishing a platform for all subsequent knowledge-based, technical urban development and intervention informed by expertise. ¹⁵ Further, the reform gave urban planning “a keenly felt townsite consciousness” for a lower-density urbanism, a “rigorous investigative technique” in the sanitary survey, and the advocacy for a water-carriage sewage system. ¹⁶

Urban planning emerges as a reformist profession in the nineteenth-century to redesign and build cities for industrial capital accumulation, while at the same time, protect publics from the social consequences of these new urban environments. Cities had already established an historic reputation as incubators for pandemics and disease (bubonic plague, yellow fever, cholera, to name a few) for precisely those qualities that were otherwise celebrated in cities: cosmopolitanism, density, exchange, and shared public spaces. Planners developed zoning, greenery, and building codes to address the challenges posed by insalubrious urban spaces, along with infrastructure celebrated by Hebbert and Peterson, to the point where the city became a demonstrably healthier human environment; particularly due to increased access to health care services and economic opportunities.

In his Risk Society, Sociologist Ulrich Beck refers to reflexive modernization as the need for new professional expertise to help mitigate the consequences of a “first round” of modernization expertise, along with the state and institutional responses that accompany this imperative. ¹⁷ Throughout its modern history, planning is continually tasked with both modernization and reflexive modernization simultaneously. In a larger sense, planning’s duality serves as an instrument of the state as part of a broader governance negotiation of private capital accumulation and public welfare. The interests are multisectoral and multifarious, and often do not align.

The contemporary COVID-19 pandemic provides an opportunity to reconsider the relationships between planning, design, and public health, and the politics and policies that both constitute and mediate these relationships. There are five contributions from across the globe—Australia, South Africa, Northern Europe, and the United States—that address the themes of public health, bodies, planning and design, and their contextual historic, institutional, and systemic meshworks.

Elizabeth Taylor and Tegan Larin explore the history of prostitution in Victoria, Australia. They track the changing public framing of sex work in which the state discursively accommodates a double standard of female condemnation as “vectors and spreaders of disease,” while men’s participation is continually accepted as inevitable for the penal colony transforming into a “respectable nation.” Citing Kristin Luker’s work, ¹⁸ they show how this same double standard also appeared in the above-mentioned nineteenth century and U.S. Progressive Era sanitary reforms, in which, “female-led campaigns against prostitution, and its sexual double standards were superseded by male-dominated sanitary and public health controls.” They interrogate planning mechanisms of “zoning, building, and planning controls” that “continue to assert an ideal of separation and euphemism: paralleling categories of bodies and women (disorder from order, commerce from residential or ‘family’ uses).” Their reflections on how gender bias, double standards, and the blaming of sex workers rather than their patrons continues today in Australia, the United States, and Canada, with the prostitution of Asian and migrant women. The salience of this point was tragically brought home during the production of the special issue when six women of Asian descent were shot and killed in three massage parlors in metro Atlanta on March 16, 2021. ¹⁹

Taylor and Larin conclude that the scientifically-informed planning reforms celebrated through public health legislation, while under the pretense of promoting a general welfare, also enforced gender bias in, finally, “promoting men’s interests.” When thinking about the dual mandate for planning in both establishing conditions for capital accumulation and simultaneously addressing the public welfare consequences of those economic processes, Taylor and Larin show that even in processes of capital reform, state planning mechanism reproduced patriarchal social structures.

L. Katie O’Connell and Nisha Botchwey also explore how public health discourse evolved in Atlanta within cycles of black community displacement. In the New Deal era, “language took on a public health narrative or discourse that equated blight to a metastatic cancer infecting surrounding neighborhoods. The best remedy was to wipe out the disease through slum clearance and urban renewal.” Academic institutions, private-sector real estate, and local government formed a pro-urban renewal alliance, exemplified in the quote by Charles Palmer, President of the National Association of Building Owners and Managers, who calls one central Atlanta community an “untended abscess” that festers “between the lovely campus of our proudest school and the office buildings in the heart of our city.” The corporeal health metaphor of an ailing body public is expressed racially, as a general threat of poor black communities to the city’s progress, but also, specifically, in terms of spatial proximity to the urban power center and its interests. This is Jim Crow spatiality rationalized through a scientific pretense, and soon after, in policy. ²⁰

O’Connell and Botchwey then move to the more recent Beltline proposal as a “green urbanism” project for creative destruction, which risks similar kinds of community displacement and historic erasure as those perpetrated on poor black communities during the era of Urban Renewal. But as they point out in the conclusion, community members were not so much against revitalization processes in general, but more in the tone and nuance of neighborhood survey conclusions, and how they misrepresented what the communities believed were its assets. The critique is not of the surveys themselves, but rather of how survey data are deployed, by whom, and to what ends. If planning literature has historically moved from the technical to the political, in the way Beck describes reflexive modernity, these cases demonstrate that such a separation of the two in practice never existed. It’s in the contextual nuance of language and interpretation within shifting public health claims that these contributions identify and sort broader relationships of governance and power.

Dirk Schubert, Cor Wagenaar, Carola Hein explore public health and the body politic in the Northern European port cities of Rotterdam, London, and Hamburg. Described graphically as “portals of death,” port cities were particularly vulnerable to health epidemics and often used immigration quarantine facilities to police and prevent the spread of contagious disease. Port cities were also notorious for their zones of exception near the docks, stigmatized as chaotic, unhealthy, overcrowded areas of immigrants and port workers. These districts housed brothels, dance halls, and shops in a multi-color cosmopolitan kaleidoscope, which became targets for social control through planning. The pretense of sanitary reform, channeled through a Spencerian social Darwinism, inspired displacement initiatives to rid the “class of slum dwellers.” The authors explore the projects and reforms in the three port cities to show how progress in science-based planning and public health were inextricably linked to problematic political tactics of social control and state disciplining. The case studies focus on the nineteenth century, a time when cities, and particularly port cities, were identified, as the authors write, as “laboratories of modernity.” Where the confluence of international trade and migration, culture, politics, health, and epidemiology were all mutually constitutive. Their meticulous article documents planning’s legal and institutional developments in these cities that proactively and (often) reactively promoted control through reform, with the countervailing recognition that, in spite of the affiliate “chaotic” conditions, ports and international trade remained the central economic force for each of the port cities.

Stephen Berry’s article takes us to another port city, New Orleans in the mid-nineteenth century, when it was ravaged with a yellow fever epidemic and “a fifth of the city died.” Berry describes institutions and health boards that were set up, in theory, to address the epidemic outbreak, and the xenophobic, misguided blaming of immigrants (southern Europeans) as the culprits of the disease's spread. But the case is a different cautionary tale. Rather than having state policies promote problematic social control through public health laws, the city simply denied the scope of the epidemic until “the interests of trade” required a token, sarcastic belittling and dismissal of the epidemic. During the Reconstruction period, after Union troops captured the city, white butchers successfully sued the city for trying to prevent them from dumping dead animal debris wherever they pleased. And won. Here, Berry deftly uses the historic example as a clear critique of the Trump administration’s denial and belittling of the COVID pandemic, while concomitantly rejecting the expert advice of government institutions like the Center for Disease Control, and the field of science in general. Berry proceeds to celebrate the advances initiated by the “big, bad data” of the 1850 US census to show how it, along with what were essentially urban planning policies (Peterson’s above-mentioned health surveys and reforms) for the doubling of human life expectancy. Berry underscores that today, “the greatest threat we face is not disease but data denial.” His celebration of “misepistemology”—the history of how we come to “unknow” what we think we know—seems to be an essential method for critical reflexivity for planning practice and history. Berry, a celebrated Civil War historian and not a traditional planning historian, is the contributor who most directly celebrates planning accomplishments. While in no way detracting from the essential critical contributions of the special issue, Berry’s point echoes recent calls for the need to advance “planning ideas that matter,” ²¹ or instances where planning interventions did have some measure of success. Even if inadvertently. With regard to capital accumulation, Berry calls this the “boomerang effect,” when a more precise humanitarianism was the result of capital’s (and the state’s) need for data and numeracy. If the other contributions demonstrate that state planning and public health policies and actions were useful but (at times, highly!) problematic, Berry’s rejoinder seems to qualify that they were often problematic, but sometimes useful.

The dialectic is taken up in James Duminy and Susan Parnell’s article on public health and its relationship to urban planning and policy in South Africa. They review the complex histories of modernity in the country through changing regimes, institutions, and policies, and the fraught postcolonial public health legacies from England and the Netherlands, described by Schubert, Wagenaar, and Hein. Duminy and Parnell divide the South African century into four periods, defined by early nationhood, the post–World War II period, the apartheid regime, and then, to the degree possible, the ways in which the state sought to reflexively redress the legacies of racism and segregation in the postapartheid era. While these periods are distinct, in the familiar palimpsest metaphor of path dependency continuities and ruptures, ²² they underscore that,

…reform efforts are inevitably bounded by historical forces. They build unevenly on what has come before; some ideas and practices “stick” and overlay others. As such, there are always residuals of previous regimes found in more recent interventions.

They highlight the temporal aspect of varying scales and chronologies of multi-level government policies and governance relationships; considerations which are necessary for a proper longue durée relational analysis of the impact of public health planning. In other words, the body politic is a complex, temporal being.

Michel Foucault, of course, was a master of understanding of how knowledge and discipline function as mechanisms of power in state control. But something happens to Foucault’s friend, Richard Sennett, as he wrote Flesh and Stone. He realized that Foucault’s pain in dying gave each of them new perspective. Not a recantation of previous work, but a heightened empathy. This leads Sennett to a new insight on bodily “awareness of pain as much as the promises of pleasure” as instructive. ²³ And at the risk of excessive optimism, he finds a new path of collective civic unity for society in this empathy. An empathy that does not walk through Greenwich Village (of the early 1990s) merely tolerating cultural diversity and largely ignoring the AIDS epidemic that was still ravaging the community, ²⁴ but rather one that has the power and potential to meaningfully bond that diversity. Sennett places his experience and belief in the Judeo-Christian tradition, but surely the words resonate beyond, for those suffering through the pandemic, and the body politic ailing:

Lurking behind the civic problems of the multi-cultural city is the moral difficulty of arousing sympathy for those who are Other. And this can only occur, I believe, by understanding why bodily pain requires a place in which it can be acknowledged…the body accepting pain is ready to become a civic body, sensible to the pain of another person, pains together on the street, at last endurable. ²⁵

In the rich contributions included in this special edition of the Journal of Planning History, we learn about bodies moving through cities and geographies in different parts of the world. Modernity and the rise of planning and public health reform brought certain trade-offs, with an increased security for some, at the expense of freedoms for others. Zygmunt Bauman writes about the “stranger” figure, an abstract threat personified to represent chaos to that modern order, and to some degree, disease was framed similarly. ²⁶ The dock areas of port cities, “barrios chinos,” and the “red light” districts for city sex workers, poor communities of color, immigrants, all the protagonists and settings for these articles, in one form or another, were framed as a “stranger” threat to the body politic. But today, as Schubert, Wagenaar, and Hein conclude, “COVID-19 has transformed the entire world into one big, global, vulnerable port city.” My hope is that the special issue, in these ongoing pandemic circumstances, will inspire, in some way, the empathy Sennett describes to become a more civic, international body politic. For Kim Wetzel (1969-2020).